Apremilast for Lichen Planopilaris and Frontal Fibrosing Alopecia: A Case Series
Importance: Lichen planopilaris and frontal fibrosing alopecia are characterized by scarring alopecia associated with pruritus, inflammation, and pain of affected areas. There is a paucity of data on treatment options for these disorders. The available management options are associated with significant adverse effects and poor efficacy.
Objective: To explore apremilast as a treatment option for refractory lichen planopilaris and frontal fibrosing alopecia
Design: This is a retrospective case series analyzing the outcomes of four patients with refractory lichen planopilaris or frontal fibrosing alopecia treated with apremilast.
Setting: The patients were seen in the faculty practice of an academic institution in New York City.
Participants: Four female patients with biopsy confirmed lichen planopilaris or frontal fibrosing alopecia refractory to currently used treatments
Observations: We report a case series of four patients with lichen planopilaris and frontal fibrosing alopecia who had failed multiple previous treatments, including intralesional steroids, anti-malarials, oral anti-inflammatory agents, minocycline, acitretin, mycophenolate mofetil, and laser treatment who responded to apremilast. While two of these patients discontinued the drug due to adverse effects such as gastrointestinal discomfort, clinical improvement was seen in every patient.
Conclusions: To date, this is the first report of the use of apremilast for lichen planopilaris or frontal fibrosing alopecia, indicating its possible use in patients refractory to other treatments.
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